MMH striving for zero staph infection rate

Ruth CampbellMidland Reporter-Telegram

Published 7:00 pm, Sunday, March 30, 2008

By Ruth Campbell

Staff Writer

Hospitals often are thought of as germ hotbeds, but Midland Memorial Hospital is fighting that misconception by screening patients who could be at risk for contracting MRSA - methicillin-resistant staph aureus, or antibiotic resistant staph infection - and placing hand sanitizer dispensers around the facility.

Infection Control Specialist Charlotte Shelton said the hospital's antibiotic resistant staph infection rate is lower than what's found in the community. The explosion of cases outside the hospital is due largely to overuse of antibiotics and mutation of the organism, said Shelton, a microbiologist.

According to the Centers for Disease Control and Prevention Web site, staph bacteria, including MRSA, can cause skin infections that may look like a pimple or boil and can be red, swollen, painful or have pus or other drainage. More serious infections may cause pneumonia, bloodstream or surgical wound infections.

"It's like a pimple that pops up and just keeps getting bigger and bigger," Shelton said.

"People think what they have is a spider bite, but it's not a spider. That's the first thing everybody thinks - that they've been bitten by something," she added.

Sixty-one percent of staph cases that come to the hospital are acquired in the community, while 40 percent are from people who come to the hospital from other care facilities or they have had staph before, Shelton said.

"Community acquired MRSA is an international problem. It is not just a West Texas problem. It's a completely different strain than health care acquired MRSA," Shelton said.

"MRSA is a transient organism," she said. "It comes and goes for each person. Once you've had MRSA, we're going to screen you for it from then on to see if you have it at that moment."

People get MRSA from direct and indirect contact. People can be "colonized" with the organism, but it doesn't make them sick. But when that person shakes hands with someone without washing their hands, or touches a cart that is then touched by someone else, it spreads, said Shelton.

The hospital now has hand sanitizers stationed outside patient rooms and nurses' stations for physicians, family members, friends and all manner of visitors.

Along with the hospital, many other establishments such as Wal-Mart, have begun putting hand sanitizers out in their businesses. Wipes can be found at local grocery stores as well.

Part of the reason for Midland Memorial's staph success is it keeps an eye on those pesky organisms.

"Since 1999, we have been tracking our hospital-associated rate of MRSA. In 2000, we implemented active surveillance cultures. That means when we identified people that were high risk to have MRSA - nursing home admits, patients from other outlying facilities, long-term care (facilities) and patients who have a previous history of it," Shelton said.

So anyone at high risk was put into isolation immediately, screened for MRSA and if the test came back negative, they were removed from isolation, she said. "When we did that, it immediately started dropping off," Shelton said.

"Midland Memorial was way ahead of its time. We started that in 2000, whereas most hospitals now across the nation have just been doing it for the past 18 months. We've taken a proactive stance toward reducing MRSA."

In 2006-07, the hospital noticed a rise in community acquired MRSA from 143 isolations in 2000 to 571 in 2007. Of those 571, a total of 350 were community acquired cases and 45 were health care acquired.

Now all patients admitted to the intensive and critical care units or for neurological or orthopedic procedures are screened for the bacteria.

Unfortunately, there is another strain of MRSA currently on the East Coast that includes a toxin. Researchers are trying to come up with a vaccination against the organism.